Suicidal behavior risks during adolescent pregnancy in a low-resource setting: A qualitative study

Background Suicide is one of the most common causes of death among female adolescents. A greater risk is seen among adolescent mothers who become pregnant outside marriage and consider suicide as the solution to unresolved problems. We aimed to investigate the factors associated with suicidal behavi...

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Veröffentlicht in:PloS one 2020-07, Vol.15 (7), p.e0236269-e0236269
Hauptverfasser: Musyimi, Christine W, Mutiso, Victoria N, Nyamai, Darius N, Ebuenyi, Ikenna, Ndetei, David M, Kabir, Russell, Spradley, Frank T
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container_issue 7
container_start_page e0236269
container_title PloS one
container_volume 15
creator Musyimi, Christine W
Mutiso, Victoria N
Nyamai, Darius N
Ebuenyi, Ikenna
Ndetei, David M
Kabir, Russell
Spradley, Frank T
description Background Suicide is one of the most common causes of death among female adolescents. A greater risk is seen among adolescent mothers who become pregnant outside marriage and consider suicide as the solution to unresolved problems. We aimed to investigate the factors associated with suicidal behavior among adolescent pregnant mothers in Kenya. Methods A total of 27 Focus Group Discussions (FGDs) and 8 Key Informant Interviews (KIIs) were conducted in a rural setting (Makueni County) in Kenya. The study participants consisted of formal health care workers and informal health care providers (traditional birth attendants and community health workers), adolescent and adult pregnant and post-natal (up to six weeks post-delivery) women including first-time adolescent mothers, and caregivers (husbands and/or mothers-in-law of pregnant women) and local key opinion leaders. The qualitative data was analyzed using Qualitative Solution for Research (QSR) NVivo version 10. Results Five themes associated with suicidal behavior risk among adolescent mothers emerged from this study. These included: (i) poverty, (ii) intimate partner violence (IPV), (iii) family rejection, (iv) social isolation and stigma from the community, and (v) chronic physical illnesses. Low economic status was associated with hopelessness and suicidal ideation. IPV was related to drug abuse (especially alcohol) by the male partner, predisposing the adolescent mothers to suicidal ideation. Rejection by parents and isolation by peers at school; and diagnosis of a chronic illness such as HIV/AIDS were other contributing factors to suicidal behavior in adolescent mothers. Conclusion Improved social relations, economic and health circumstances of adolescent mothers can lead to reduction of suicidal behaviour. Therefore, concerted efforts by stakeholders including family members, community leaders, health care workers and policy makers should explore ways of addressing IPV, economic empowerment and access to youth friendly health care centers for chronic physical illnesses. Prevention strategies should include monitoring for suicidal behavior risks during pregnancy in both community and health care settings. Additionally, utilizing lay workers in conducting dialogue discussions and early screening could address some of the risk factors and reduce pregnancy- related suicide mortality in LMICs.
doi_str_mv 10.1371/journal.pone.0236269
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A greater risk is seen among adolescent mothers who become pregnant outside marriage and consider suicide as the solution to unresolved problems. We aimed to investigate the factors associated with suicidal behavior among adolescent pregnant mothers in Kenya. Methods A total of 27 Focus Group Discussions (FGDs) and 8 Key Informant Interviews (KIIs) were conducted in a rural setting (Makueni County) in Kenya. The study participants consisted of formal health care workers and informal health care providers (traditional birth attendants and community health workers), adolescent and adult pregnant and post-natal (up to six weeks post-delivery) women including first-time adolescent mothers, and caregivers (husbands and/or mothers-in-law of pregnant women) and local key opinion leaders. The qualitative data was analyzed using Qualitative Solution for Research (QSR) NVivo version 10. Results Five themes associated with suicidal behavior risk among adolescent mothers emerged from this study. These included: (i) poverty, (ii) intimate partner violence (IPV), (iii) family rejection, (iv) social isolation and stigma from the community, and (v) chronic physical illnesses. Low economic status was associated with hopelessness and suicidal ideation. IPV was related to drug abuse (especially alcohol) by the male partner, predisposing the adolescent mothers to suicidal ideation. Rejection by parents and isolation by peers at school; and diagnosis of a chronic illness such as HIV/AIDS were other contributing factors to suicidal behavior in adolescent mothers. Conclusion Improved social relations, economic and health circumstances of adolescent mothers can lead to reduction of suicidal behaviour. Therefore, concerted efforts by stakeholders including family members, community leaders, health care workers and policy makers should explore ways of addressing IPV, economic empowerment and access to youth friendly health care centers for chronic physical illnesses. Prevention strategies should include monitoring for suicidal behavior risks during pregnancy in both community and health care settings. Additionally, utilizing lay workers in conducting dialogue discussions and early screening could address some of the risk factors and reduce pregnancy- related suicide mortality in LMICs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0236269</identifier><identifier>PMID: 32697791</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adolescent mothers ; Adolescents ; Aggression ; Alcohol abuse ; Biology and Life Sciences ; Caregivers ; Chronic illnesses ; Demographic aspects ; Developing countries ; Domestic violence ; Drug abuse ; Economics ; Empowerment ; Health aspects ; Health behavior ; Health care ; Health care industry ; Health risks ; Health services ; HIV ; Human immunodeficiency virus ; Illnesses ; Leadership ; Medical diagnosis ; Medical personnel ; Medicine and Health Sciences ; Mental disorders ; Mental health ; Opinion leaders ; Peers ; People and Places ; Pessimism ; Policy making ; Poverty ; Pregnancy ; Psychological aspects ; Qualitative analysis ; Qualitative research ; Rejection ; Risk analysis ; Risk factors ; Risk taking ; Social aspects ; Social interactions ; Social isolation ; Social relations ; Social Sciences ; Studies ; Substance abuse ; Suicidal behavior ; Suicide ; Suicides &amp; suicide attempts ; Teenage pregnancy ; Teenagers ; Tests ; Workers</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0236269-e0236269</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Musyimi et al. 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A greater risk is seen among adolescent mothers who become pregnant outside marriage and consider suicide as the solution to unresolved problems. We aimed to investigate the factors associated with suicidal behavior among adolescent pregnant mothers in Kenya. Methods A total of 27 Focus Group Discussions (FGDs) and 8 Key Informant Interviews (KIIs) were conducted in a rural setting (Makueni County) in Kenya. The study participants consisted of formal health care workers and informal health care providers (traditional birth attendants and community health workers), adolescent and adult pregnant and post-natal (up to six weeks post-delivery) women including first-time adolescent mothers, and caregivers (husbands and/or mothers-in-law of pregnant women) and local key opinion leaders. The qualitative data was analyzed using Qualitative Solution for Research (QSR) NVivo version 10. Results Five themes associated with suicidal behavior risk among adolescent mothers emerged from this study. These included: (i) poverty, (ii) intimate partner violence (IPV), (iii) family rejection, (iv) social isolation and stigma from the community, and (v) chronic physical illnesses. Low economic status was associated with hopelessness and suicidal ideation. IPV was related to drug abuse (especially alcohol) by the male partner, predisposing the adolescent mothers to suicidal ideation. Rejection by parents and isolation by peers at school; and diagnosis of a chronic illness such as HIV/AIDS were other contributing factors to suicidal behavior in adolescent mothers. Conclusion Improved social relations, economic and health circumstances of adolescent mothers can lead to reduction of suicidal behaviour. Therefore, concerted efforts by stakeholders including family members, community leaders, health care workers and policy makers should explore ways of addressing IPV, economic empowerment and access to youth friendly health care centers for chronic physical illnesses. Prevention strategies should include monitoring for suicidal behavior risks during pregnancy in both community and health care settings. Additionally, utilizing lay workers in conducting dialogue discussions and early screening could address some of the risk factors and reduce pregnancy- related suicide mortality in LMICs.</description><subject>Adolescent mothers</subject><subject>Adolescents</subject><subject>Aggression</subject><subject>Alcohol abuse</subject><subject>Biology and Life Sciences</subject><subject>Caregivers</subject><subject>Chronic illnesses</subject><subject>Demographic aspects</subject><subject>Developing countries</subject><subject>Domestic violence</subject><subject>Drug abuse</subject><subject>Economics</subject><subject>Empowerment</subject><subject>Health aspects</subject><subject>Health behavior</subject><subject>Health care</subject><subject>Health care industry</subject><subject>Health risks</subject><subject>Health services</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Illnesses</subject><subject>Leadership</subject><subject>Medical diagnosis</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Opinion leaders</subject><subject>Peers</subject><subject>People and Places</subject><subject>Pessimism</subject><subject>Policy making</subject><subject>Poverty</subject><subject>Pregnancy</subject><subject>Psychological aspects</subject><subject>Qualitative analysis</subject><subject>Qualitative research</subject><subject>Rejection</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Risk taking</subject><subject>Social aspects</subject><subject>Social interactions</subject><subject>Social isolation</subject><subject>Social relations</subject><subject>Social Sciences</subject><subject>Studies</subject><subject>Substance abuse</subject><subject>Suicidal behavior</subject><subject>Suicide</subject><subject>Suicides &amp; 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A greater risk is seen among adolescent mothers who become pregnant outside marriage and consider suicide as the solution to unresolved problems. We aimed to investigate the factors associated with suicidal behavior among adolescent pregnant mothers in Kenya. Methods A total of 27 Focus Group Discussions (FGDs) and 8 Key Informant Interviews (KIIs) were conducted in a rural setting (Makueni County) in Kenya. The study participants consisted of formal health care workers and informal health care providers (traditional birth attendants and community health workers), adolescent and adult pregnant and post-natal (up to six weeks post-delivery) women including first-time adolescent mothers, and caregivers (husbands and/or mothers-in-law of pregnant women) and local key opinion leaders. The qualitative data was analyzed using Qualitative Solution for Research (QSR) NVivo version 10. Results Five themes associated with suicidal behavior risk among adolescent mothers emerged from this study. These included: (i) poverty, (ii) intimate partner violence (IPV), (iii) family rejection, (iv) social isolation and stigma from the community, and (v) chronic physical illnesses. Low economic status was associated with hopelessness and suicidal ideation. IPV was related to drug abuse (especially alcohol) by the male partner, predisposing the adolescent mothers to suicidal ideation. Rejection by parents and isolation by peers at school; and diagnosis of a chronic illness such as HIV/AIDS were other contributing factors to suicidal behavior in adolescent mothers. Conclusion Improved social relations, economic and health circumstances of adolescent mothers can lead to reduction of suicidal behaviour. Therefore, concerted efforts by stakeholders including family members, community leaders, health care workers and policy makers should explore ways of addressing IPV, economic empowerment and access to youth friendly health care centers for chronic physical illnesses. Prevention strategies should include monitoring for suicidal behavior risks during pregnancy in both community and health care settings. Additionally, utilizing lay workers in conducting dialogue discussions and early screening could address some of the risk factors and reduce pregnancy- related suicide mortality in LMICs.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32697791</pmid><doi>10.1371/journal.pone.0236269</doi><tpages>e0236269</tpages><orcidid>https://orcid.org/0000-0002-8828-2959</orcidid><orcidid>https://orcid.org/0000-0002-3329-6296</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adolescent mothers
Adolescents
Aggression
Alcohol abuse
Biology and Life Sciences
Caregivers
Chronic illnesses
Demographic aspects
Developing countries
Domestic violence
Drug abuse
Economics
Empowerment
Health aspects
Health behavior
Health care
Health care industry
Health risks
Health services
HIV
Human immunodeficiency virus
Illnesses
Leadership
Medical diagnosis
Medical personnel
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title Suicidal behavior risks during adolescent pregnancy in a low-resource setting: A qualitative study
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